Quantitative assessment of subclinical spasticity in human T-cell lymphotropic virus type I infection

被引:9
|
作者
Zunt, JR
Alarcón, OV
Montano, S
Longstreth, WT
Price, R
Holmes, KK
机构
[1] Univ Washington, Sch Med, Dept Neurol, Seattle, WA USA
[2] Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA
[3] Univ Washington, Sch Med, Dept Epidemiol, Seattle, WA USA
[4] Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98195 USA
[5] Univ Washington, Sch Med, Ctr AIDS & STD, Seattle, WA 98195 USA
[6] Univ Nacl Mayor San Marcos, Inst Ciencias Neurol, Lima, Peru
关键词
D O I
10.1212/WNL.53.2.386
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: To compare human T-cell lymphotrophic virus type I(HTLV-I) seropositive and seronegative women for symptoms and signs of spasticity. Background: Infection with HTLV-I causes tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM). Certain populations, including female commercial sex workers (FSW), are at increased risk of developing this infection. Fewer than 5% of HTLV-I-seropositive persons develop TSP/HAM, which is typically associated with spasticity. Methods: Cross-sectional study of 255 registered FSW in Callao, Peru, involving a questionnaire detailing demographics and neurologic symptoms, standard neurologic examination, quantitative assessment of spasticity (QSA) of muscle tone, and serologic testing for HTLV-I. Participants and examiners were blinded to serology results. Results: On the questionnaire and neurologic examination, none of the 32 HTLV-I-seropositive or 223 seronegative women had signs or symptoms of spasticity. However, mean values on QSA were significantly higher among seropositive women (27.1 Newton-meters/radian [N-m/r]) than among seronegative women (21.6 N-m/r, p = 0.01), indicating a subclinical increase in lower extremity tone. With values of QSA divided into tertiles, and the first tertile serving as the comparison group, the odds ratio for seropositivity was 1.4 (95% confidence interval [CI] 1.0 to 2.0) in the second and 3.1 (95% CI 2.2 to 4.3) in the third tertile, after adjusting for age and place of birth. Conclusions: Although a standard neurologic evaluation could not distinguish beta een women with and without HTLV-I infection, QSA indicated significantly increased lower extremity tone in those with infection. Long-term follow-up will determine whether these subclinical findings in asymptomatic women progress to overt TSP/HAM.
引用
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页码:386 / 390
页数:5
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